The Criminalization of Mental Illness

Prison cell block
Prison cell block. Source: Bob Jagendorf, Creative Commons.

It is no secret that the United States has an issue of overcrowding prisons, which can lead to many issues regarding quality of life in prisons. Overcrowding in prisons is not just a problem in the United States; over 100 other countries also have this issue. In many countries, the criminalization of mental health is a factor that is compounding the issue. Individuals with severe mental illnesses not only need treatment that prisons don’t provide, but also can be put in dangerous situations when they are in prison. Despite this, they are more likely to end up in prison than in treatment.

Up until the 1960s in the United States, when someone had a severe mental illness, they were typically placed in a mental institution or asylum. In an effort to provide patients in mental institutions better community-based care and reduce government spending, the process of deinstitutionalization began. However, that is not how it played out. While the movement gave those with mental illness more rights and turned society away from locking them up, it released some that would have benefitted from long-term care that community centers could not provide. However, with many patients moving out of long-term treatment facilities, many of these facilities were shutting down. This left community mental health centers to try to treat illnesses they were not originally intended to. Another issue arose when insufficient funding was allocated for the community mental health centers, further overwhelming the new system. Because the difficulty of the transition from institutionalization to community care was underestimated, many—then and today—have gone without treatment. The lack of treatment for serious mental illness, like Schizophrenia, has led to the incarceration of many people with mental illness who should instead be treated.

Not Guilty by Reason of Insanity

Another issue that has contributed to the criminalization of mental illness is the difference between the clinical definition of mental illness and the legal definition. The diagnosis of mental illness is dictated by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The law, however, sees mental illness as symptoms that impair mental functioning. The main diagnoses that fits into the legal definition are psychotic disorders, such as Schizophrenia. Even if someone has been diagnosed with a psychotic disorder, when pleading not guilty by reasoning of insanity, their lawyer must show that they were having symptoms at the time of the crime that contributed to said crime. This can be a difficult task as some states require that the symptoms are so severe that the defendant didn’t know that the crime was illegal. Even in cases where the defendant has shown this to be true, some juries will give a verdict of guilty to ensure that someone is held accountable for the offense.

Some states have gotten rid of the insanity plea altogether, while others have changed it to “guilty because of mental illness” meaning after treatment, they must serve their sentence in prison. This can sometimes put the progress a patient has made in jeopardy, as prisons are not a suitable environment for maintaining a newly achieved healthy mental state. In states where not guilty by reason of insanity is still in effect, those found not guilty by reason of insanity are supposed to be released after sanity has been restored. Yet, this is rarely the case; due to fear they will go off their medicine and commit the same violent crimes, many are held in treatment facilities indefinitely. With the threat of this outcome overhead, many opt out of the not guilty by reason of insanity plea and are instead place into a prison where they will not receive the appropriate care.

Because of the law’s strict definition of mental illness, many are being placed in already crowded, underfunded prisons. Because of the lack of mental health professionals, prisoners in some states, including Nebraska, may not receive medications for mental illnesses or have access to talk to counselors. This can cause the reemergence of once-controlled symptoms, making the prisoner with a mental illness a danger not only to himself, but also to others. Additionally, many with severe mental illness are put in solitary confinement for long periods of time. Psychologists who have studied the effects of solitary confinement have seen a pattern of increased mental health problems in people who were originally neurotypical. If this is true, the effects on prisoners with mental illness could be devastating. Not only are people being sent to prison when they should receive treatment, they are also being put in situations that make their symptoms worse and make it harder to reenter into society if their sentence allows.

Substance Use Criminalization

In addition to violent crimes committed because of mental illness, many nonviolent acts associated with mental illness are criminalized; Substance Use Disorders are recognized by the DSM V and are therefore diagnosable and treatable, but the law instead criminalizes it. While at any given time there are more convictions for violent crimes, more people are sent to prison a year for drug-related crimes than violent crimes. Studies have shown that those imprisoned for drug-use are unlikely to receive treatment and often return to using drugs once released because they lack the resources that treatment would have given them. Sending people with Substance Abuse Disorders to jail does not improve their illness.

Not only those with Substance abuse disorder are affected by this criminalization; those diagnosed with another mental illness are five to eighteen times more likely to have a comorbid Substance Use Disorder. This can further prevent someone who needs treatment from receiving it. Most prisons don’t have adequate resources to treat prisoners with mental illness, so imprisoning people for crimes that are directly tied to mental illness can be detrimental to their treatment and future.

Current solutions

Some states are trying to combat the increasing proportion of prisoners with mental illness not receiving treatment. With our corrections system slowly catching up with our understanding of mental illness, states—like California—are beginning to consider replacing their old jails, not with new ones exactly like them, but instead with centers focused on rehabilitation. They are not calling for moving all criminals with mental illness out of prisons, but instead treating those with mental illness while they serve their sentence. Additionally, they do want to increase the diversion from jails, but that will be done on a case-by-case basis and only for those who have committed a crime because of mental illness.

Stigma

Ultimately, the criminalization of mental illness has a lot to do with the stigma surrounding it. The general population connects mental illness with violence, which leads to harsher punishments. As a society, we need to reduce stigma before any change can happen. If we continue to see those with mental health problems as inherently violent, they will continue to be prosecuted and sentenced unjustly.

If The Steel Walls Could Talk: The Abuse of Human Rights Through The Use Of Solitary Confinement

This prisoner held in solitary confinement is kept in isolation with little sunlight.
Source:Yahoo Images

One of the saddest stories that I ever listened to was the story of Kalief Broder. He was a young man from the Bronx who spent three years in jail because he could not pay for his bail after being arrested in 2010.  I heard about this story while watching 13th, the documentary that examines the connection of slavery to the mass incarceration of Black people in America. While I looked at Broder’s experience through the lens of racial injustice, there was another piece to this disheartening story. Broder also spent two years in solitary confinement without being convicted of a crime or having a trial. Broder was finally released from prison in 2013; two years later, he committed suicide by hanging himself in his parents home. 

Kalief Broder, a victim of the effects of solitary confinement.
Source: Yahoo Images

After making the connection between solitary confinement and mental illness, I started doing more research on this and thought about it in the context of human rights. The connection stems from the lack of connection between human rights and the rights of prisoners. In the context of solitary confinement and human rights, the overpractice of solitary confinement violates the human rights of prisoners. These violations include torture, mental abuse lack of resources such as sunlight and social interaction. To give a background on human rights in the scope of prisoners, their rights have been recognized by the United Nations to protect those rights. According to the Office of the High Commissioner in the United Nations Human Rights Office of the High Commissioner, the basic principles on the treatment and conditions inmates were adopted and proclaimed by the United Nations in December of 1990. One of the most profound statements stated that “All prisoners shall be treated with the respect due to their inherent dignity and value as human beings”.  Although their rights have been recognized by the human rights community, most of the rights of prisoners are often abused due to this underlying notion that perhaps prisoners are not even seen as humans and do not need their rights to be protected. If their rights and humanity were protected by the state, then their rights would not be abused.

To give a context to the global prison system, the United States plays a big role within it. According to the Prison Policy Initiative, the United States has the highest incarceration rate worldwide. The use of solitary confinement is also used widely within the United States. The definition of solitary confinement is the isolation of a prisoner in a confined cell as a form of punishment. According to the Human Rights Watch, prisoners are “Prisoners in solitary typically spend 22 to 24 hours a day locked in small, sometimes windowless, cells sealed with solid steel doors”. While confined they do not have any contact with other inmates besides a prison guard that serves them their meals through a small opening on the door.  The National Public Radio  did a special series on the practice of solitary confinement. In the series, the hosts explain that the first documented use of solitary confinement in 1829. It was used in the Eastern State Penitentiary in Philadelphia. Based in Quaker belief, it was seen as a place where criminals were locked in a stone cell with a Bible to pray and repent for the crimes. Although it was seen as a place for rehabilitation, many criminals went insane and committed suicide while being locked in the cells. After this, solitary confinement slowly stopped being practiced for many decades. 

The Eastern State Penitentiary in Philadelphia, one of the earliest places where solitary confinement was used in the 1800s.
Source: Yahoo Images

This practice was proven to be detrimental to the mental health of human beings over the course of decades. As the statement proves to be true, it is still used widely in the United States. The Human Rights Watch has offered research to the growing use of solitary confinement in prisons. The research states that solitary confinement in US prisons is imposed for different reasons, but most commonly it is used as punishment for breaches of discipline such as disciplinary segregation to manage prisoners considered to be particularly difficult or dangerous through administrative segregation. The increase in solitary confinement in the United States has occurred primarily through administrative segregation, and particularly the segregation of prisoners in special super-maximum security facilities, which are built solely for this purpose. Solitary confinement is not only used to punish prisoners physically but also mentally. 

According to the American Civil Liberties Union or ACLU, the U.N. Special Rapporteur on torture, Juan Mendez, has condemned the use of solitary confinement, finding that the imposition of this punishment can constitute torture, cruel, inhuman or degrading treatment or punishment. The effects of solitary confinement are so damaging that it has been deemed as torture for human beings. According to the Human Rights Campaign, prisoners that are held in solitary confinement, they do not have opportunities for meaningful social interaction with other prisoners. The contact that they do have with officers is very brief and interaction only occurs when prisoners are being handed food through a small door. Phone calls and any visits by family and loved ones are severely restricted or prohibited. During the week, prisoners are let out for showers and solitary exercise in a small, enclosed space, sometimes indoors on a few times a week. They often have very little or no access to educational and recreational activities or other sources of mental stimulation. Lastly, they are usually handcuffed, shackled, and escorted by correctional officers every time they leave their cells. This also goes into them not having any access to sunlight or adequate housing that it is fit for the shelter of any human being. The research from the American Civil Liberties Union shows that the practice of solitary confinement can also damage an inmate on the psychological level. There are quite a few destructive effects of solitary confinement that include perceptual distortions and hallucinations increased anxiety and nervousness, along with self mutilation, severe chronic depression, and lower levels of brain activity. 

Another issue with this is the use of solitary confinement for inmates who are mentally ill. Statistics from ACLU state that most experts would estimate that approximately 10 to 20 percent of all prisoners in United States prisons suffer from a mental illness.  One story noted from ACLU from a prisoner who was mentally ill who spent time in solitary confinement actually set himself on fire and succumbed from his burns while another prisoner hung himself with a washcloth. It was also noted that prisoners were found to have attempted or have committed suicide, ingested razors, or have  pummeled their heads against walls. The issue with solitary confinement is the damaging psychological effects that it can have on the individual. By limiting social interaction, the prison is depriving one of social interaction that  is crucial for psychological growth and when that is interrupted that could have a detrimental influence on the individual. For those that are released from prison, they still face psychological harm from their time spent in solitary confinement. Craig Haney, PhD is a member of the American Psychology Association and a professor of psychology at the University of California who evaluates the psychological effects of solitary confinement on a human being. He states that “one of the very serious psychological consequences of solitary confinement is that it renders many people incapable of living anywhere else.” Then, when prisoners are released into cells or back into society, they are often overwhelmed with anxiety.” They actually get to the point where they become frightened of other human beings,” he said. These long term effects from solitary confinement leave a damaging mark on the humanity of these people and mentally abuses their human rights to the worst degree.

The effects of solitary confinement has damaging effects on the mental psyche of prisoners shown by this prisoner who is being held in isolation.
Source: Yahoo Images

With all of these human rights abuses, there should be an effort to abolish solitary confinement in prisons all over the world. It has too many detrimental effects on human beings and abuses the rights of prisoners and as members of society. There have been efforts by the American Civil Liberties Union to abolish solitary confinement. Their statement reads: “Over the last two decades corrections systems have increasingly relied on solitary confinement as a prison management tool – even building entire institutions called “supermax prisons” where prisoners are held in conditions of extreme isolation, sometimes for years or decades. But solitary confinement jeopardizes our public safety, is fundamentally inhumane and wastes taxpayer dollars. We must insist on humane and more cost-effective methods of punishment and prison management”.  In order for this issue to be solved, there must be major reform within the prison system and more access to mental health resources and rehabilitation services for prisoners. It does not do any good to lock people into cages to the point where they do not even know that they are human anymore. Even though they have committed crimes, these people are still human beings and their rights deserve to be protected. 

a demonstration by the people of Pennsylvania to abolish the practice of solitary confinement
Source: Yahoo Images